MEDICARE: OHIO LIFE BALANCE PHYSICAL THERAPY LIMITED PARTNERSHIP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1740500693
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OHIO LIFE BALANCE PHYSICAL THERAPY LIMITED PARTNERSHIP

Provider Business Mailing Address
First Line	:	5672 W BROAD ST
Second Line	:
City	:	GALLOWAY
State	:	OH
Zip	:	43119-8127
Country	:	US
Telephone Number	:	614-878-9000
Fax Number	:	614-878-8881

Provider Business Practice Location Address
First Line	:	5672 W BROAD ST
Second Line	:
City	:	GALLOWAY
State	:	OH
Zip	:	43119-8127
Country	:	US
Telephone Number	:	614-878-9000
Fax Number	:	614-878-8881

Authorized Official
Title or Position	:	VP, AUTHORIZED OFFICIAL
Name	:	CHRISTOPHER D CORRIGAN
Credential	:
Telephone Number	:	713-297-7000

Provider Enumeration Date	:	06/02/2010
Last Update Date	:	02/10/2011

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